From the Pharmacy to Kitchen Counter

I became a pharmacist long before I became interested in baking. In fact, my first batch of chocolate chip cookies were too salty. The second and future batches were too hard and oddly shaped. I did master oatmeal-craisin cookies, which made it into my repertoire of baked goods. Soon this list expanded to banana bread and chocolate cake from scratch. Recently, I made pumpkin bread, pumpkin pound cake, banana-chocolate chip bundt cake, and oatmeal-chocolate chip-craisin cookies. I noticed that I have been bringing my pharmacy skills into the kitchen. Perhaps, like my techniques used on the pharmacy counter, my baking skills just needed practice and, more importantly, accuracy with the measurements and the order of combining ingredients. Baking is essentially compounding the extemporaneous formulations that I used to love making in the hospital pharmacy. So, now I'm measuring milk, oil, and water with a measuring cup instead of cherry syrup or water in a graduated cylinder. I'm molding cookies instead of suppositories. I'm crushing cloves instead of tablets with a mortar and pestle. I'm storing the finished products in Tupperware instead of medicinal bottles and jars. The ultimate users were pediatric patients; the ultimate consumers are my children. Who says I'm not practicing?

Is it a positive or negative PPD?

I took my 4-year-old daughter for her physical the day after her birthday. Since she will be entering kindergarten next year, she needed some vaccines (MMR, varicella, DTaP, and IPV) and a PPD (purified protein derivative) skin test for tuberculosis (TB). I was prepared to bring her back to the office in 2 days (usually 48-72 hours after being placed) to have her forearm read, but was told by the nurse that I just have to call an extension and leave a message. Did I make a face when I heard that? Surprise is probably a good word to describe how I felt. At work, they were very religious about making a worker return to the clinic for the reading by a nurse. If one were to miss it, then a new test had to be planted. I know, different situation. It's a good thing I was a clinical pharmacist and have seen what positive PPD results can look like. I am also confident about reporting negative PPD results through personal experience. However, I cannot imagine placing this kind of responsibility on a parent, especially without any written instructions. Granted my daughter is not at high risk for having TB, nor has she been recently exposed to someone with TB, but some pictorial guidance would be helpful. What if the parent forgot to look at the arm or call the office? Hopefully the nurse will call and remind the family. My daughter's arm has no raised bumps or redness, and yes, I called and left a message. When in doubt, though, ask the doctor to check it out.

For more information about TB and testing, check out:

• Tuberculosis Facts for Parents (about.com)
• Tuberculosis (keepkidshealthy.com)
• Tuberculosis tutorial video (National Institute of Health)
• Get the Facts about Tuberculosis (Centers for Disease Control and Prevention)

Take the key and lock 'em up

I'm talking about medicine bottles. I just saw a blurb in a recent issue of Fairfield Parent about the new MedSafe, "a first-of-its-kind electronic lockbox...to help parents safely and conveniently store prescription medications and keep their children safe." It holds up to 15 (standard) bottles of prescription medicine. (Bottles for liquid medicine would probably change that number.) Good to know that if your child figures out the combination, there are over 19, 000 changeable ones (yikes, another password to remember with mommy brain)! Affix it to the inside of any medicine cabinet (a medicine cabinet within a medicine cabinet?) or store it in a dresser drawer, kitchen cabinet, or closet. Personally, I'm content with storing my family's medicines on a high shelf where even I need to tiptoe to reach.

While MedSafe looks like a good idea, it does not replace education. Begin explaining early in a child's life that medicine is not candy or food. Try to avoid taking medicine in front of children. Mimicry is amazing to watch, but it could be deadly if children have access to your medicine. Oh, and if you do decide to get the safe, please don't store your child's epinephrine pen or other emergency items in there! Precious seconds might be lost from trying to remember the key.

I like to move it, move it

Well, my son is almost 19-months and he still isn't walking. He is one heck of a scoocher, though, and he just started crawling at about 17 months. Although the pediatrician has stated that he will pick up walking at his own pace, I decided to start up once weekly physical therapy for him again through Connecticut's Birth to Three system (early intervention). In a matter of days, he has picked up crawling up stairs on his own. I've also noticed stronger leg strength when he's standing (with support). He's also pulling himself into a standing position more readily. Yesterday, I showed him how to cruise. He can also climb up the steps and put himself into a sliding position on a portable slide that we picked up from a tag sale. This is all great progress within a matter of weeks! It helps that his new physical therapist is more successful in engaging him into activities, whereas our last therapist was not able to connect with him due to his separation anxiety. What have I learned? A little help makes a huge difference sometimes. Also, a little denial can be a setback for major milestones.